The World Bank pioneered global HIV and AIDS financing early in the emergency and remains committed to achieving Millennium Development Goal 6, to halt by 2015 and begin to reverse the spread of HIV and AIDS, through prevention, care, treatment, and mitigation services for those affected by HIV and AIDS.
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Ratings for the HIV/AIDS Prevention and
Control Project for Grenada were as follows: outcomes were
moderately unsatisfactory, the risk to development outcome
was substantial,... Show More + Bank performance was moderately
unsatisfactory, and Borrower performance was also moderately
unsatisfactory. Some lessons learned included: the project
design should match the country context and the capacity
available in-country. Using a template model that may work
well in other countries creates implementation delays and
unrealistic expectations. This applies especially to
commitment by all stakeholders, especially Civil Society
Organization (CSO) and to establishing the appropriate
institutional framework for program implementation.
Technical and fiduciary teams struggle to cope with
responsibilities at inception in a health sector that is a
first time borrower and where collaboration between more
than one ministry is key to successful implementation.
Therefore, ensuring that the operations manual is simple to
use and clearly outlines institutional and project team
roles and responsibilities as well as
authority/responsibility relationships is essential to the
success of the project. The project fell short of
accomplishing all its objectives. The timeframe needs to be
realistic, especially if working in countries where
implementing agencies have weak executing capacity and no
history of involvement in complex multi-sector programs and
where the leading sector is a first time borrower. The World
Bank needs to be strongly involved from the beginning
insisting on a quality operational manual that spells out
roles and responsibility of implementing agencies, which is
to be held accountable, fiduciary capabilities and proper
procedures for engaging line ministries and contracting with
civil society; and supervision missions staffed with
experienced professionals able to provide technical assistance. Show Less -

The Government of Grenada's
HIV/AIDS Prevention and Control Project is funded under the
Multi-Country APL for the Caribbean Region, with the
following objectives: 1)... Show More + curbing the spread of HIV/AIDS
epidemic; 2) reducing the morbidity and mortality attributed
to HIV/AIDS; 3) improving the quality of life for persons
living with HIV/AIDS (PLWAs); and 4) developing a
sustainable organizational and institutional framework for
managing the HIV/AIDS epidemic over the longer term. There
are four project components. The first component identifies
areas of systematic discrimination, introduces measures
prohibiting discrimination and human rights denial, promotes
behavioral change, maintains people's awareness of
HIV/AIDS risks and protection measures as well as safe sex
practices, and launches a major schools initiative, resorts
to non-traditional practices, wages mass media campaigns,
and conducts special presentations. The second component
supports clinical preventive interactions for reducing and
controlling HIV/AIDS; clinical management of sexually
transmitted diseases, prevention of mother-to-child
transmission, tuberculosis diagnosis and treatment, and
blood bank and laboratories quality control. The third
component upgrades current services available for providing
care to PLWA, and for treatment, including introducing
triple anti-retroviral therapy; and finances manuals and
staff training. The fourth component funds institutional
development, management, and surveillance. Show Less -

The report audits biomedical waste
management practices in Grenada, based on the most relevant
law, the Waste Management Act (2001), only recently
enforced. Regrettably,... Show More + except for some general requirements,
specific biomedical waste regulations are non-existent, and
likewise, the policies in health facilities regarding
comprehensive waste management, with little or no training
for biomedical waste management. The recommendations this
report provides to minimize biomedical wastes, include
stipulations that new biomedical waste treatment
technologies, will be presented in another report. It does
nevertheless review practices, the most usual being
incineration of wastes. However, this practice for regular
wastes - which include plastics - as well as biomedical
wastes, and which does not segregate wastes, poses fire
hazards to surrounding vegetation, including threats from
other combustible materials, in addition to releasing air
pollutants - toxic dioxins, acid gases, particulates and
heavy metals. It is thus recommended the use of incinerators
be minimized, and, that halogenated plastics, heavy metals,
pressurized containers, and organic solvents be not burned
under any circumstance. Instead, biomedical waste should be
encapsulated, and buried in selected landfills, under
special arrangement with the Solid Waste Management
Authority. Specific short-term recommendations are provided
for each facility, and include the treatment of chemical
waste as hazardous materials, not to be drained, but rather
disposed of at selected landfills as well. General long-term
recommendations suggest strengthened laws and regulations;
institutional policy; administration and organization;
occupational safety and health; waste segregation and
classification; and, adequate handling and transportation
procedures, while contingency planning, should also include
training and education. Above all, stakeholder awareness and
participation, should lay the foundation for the development
of a national biomedical waste management plan. Show Less -